Karen Bringhurst
5 MR. WILSON: I THINK WE'D CALL KAREN BRINGHURST TO
6 THE STAND AT THIS TIME, YOUR HONOR.
7 THE COURT: KAREN BRINGHURST. MS. BRINGHURST, IF
8 YOU'LL COME RIGHT UP HERE, PLEASE. RAISE YOUR RIGHT HAND AND
9 FACE THE CLERK, SHE'LL PLACE YOU UNDER OATH.
10 KAREN BRINGHURST,
11 HAVING BEEN DULY SWORN, WAS EXAMINED AND
12 TESTIFIED AS FOLLOWS:
13 THE COURT: HAVE A SEAT UP HERE, PLEASE, GIVE US
14 YOUR FULL NAME AND SPELL YOUR LAST NAME.
15 THE WITNESS: KAREN BRINGHURST, B-R-I-N-G-H-U-R-S-T.
16 THE COURT: YOU MAY PROCEED, MR. WILSON.
17 MR. WILSON: THANK YOU, YOUR HONOR.
18 DIRECT EXAMINATION
19 BY MR. WILSON:
20 Q. KAREN, WHERE DO YOU CURRENTLY RESIDE?
21 A. SALT LAKE CITY.
22 Q. WHAT IS THE NATURE OF YOUR OCCUPATION?
23 A. I'M A REGISTERED NURSE.
24 Q. AND HOW LONG HAVE YOU BEEN IN THE NURSING FIELD?
25 A. TWENTY-TWO YEARS NOW.
1 Q. DO YOU PRACTICE IN A PARTICULAR AREA IN THE NURSING
2 FIELD?
3 A. YES. THE OPERATING ROOM.
4 THE JUROR: I CAN'T HEAR.
5 THE COURT: CAN'T HEAR?
6 THE WITNESS: TALK LOUDER.
7 THE COURT: PULL THAT MICROPHONE DOWN JUST A LITTLE
8 BIT. OKAY.
9 Q. (BY MR. WILSON) YOU PRACTICE IN A PARTICULAR AREA IN THE
10 NURSING FIELD?
11 A. YES. THE OPERATING ROOM.
12 Q. OKAY. HAS THAT BEEN PRIMARILY THE AREA THAT YOU'VE
13 PRACTICED ALL OF YOUR CAREER?
14 A. YES, THAT'S CORRECT.
15 Q. NOW, YOU'RE THE DAUGHTER OF MARY CRANE; IS THAT CORRECT?
16 A. YES.
17 Q. AND I SHOW YOU WHAT'S BEEN MARKED AS EXHIBIT
18 PLAINTIFF'S -- STATE'S EXHIBIT NUMBER 4 AND ASK YOU TO TAKE A
19 LOOK AT THAT, IF YOU WOULD, PLEASE. IS THAT A PICTURE OF
20 YOUR MOTHER?
21 A. YES, IT IS.
22 Q. DO YOU KNOW WHEN THAT PICTURE WAS TAKEN, KAREN?
23 A. IT WAS JUST THE CHRISTMAS BEFORE SHE PASSED AWAY, 1995.
24 Q. SO AROUND DECEMBER 25TH OF '95?
25 A. YES. MAYBE A LITTLE EARLIER IN THE MONTH.
1 Q. ALL RIGHT. SO I ASSUME THAT ACCURATELY DEPICTS HER
2 APPEARANCE AT THE TIME SHE ENTERED THE GEROPSYCH UNIT IS THAT
3 CORRECT?
4 A. YES.
5 Q. WHERE DID YOUR MOTHER RESIDE -- WELL LET ME ASK IT THIS
6 WAY: IT'S TRUE, IS IT NOT, KAREN, THAT YOUR MOTHER SUFFERED
7 A STROKE I THINK IT WAS IN 1990?
8 A. YES, THAT'S CORRECT.
9 Q. AND AFTER SUFFERING THAT STROKE, CAN YOU TELL US WHAT
10 KIND OF CONDITION, PHYSICAL CONDITION THE STROKE LEFT HER IN?
11 A. SHE HAD WEAKNESS ON THE LEFT SIDE OF HER BODY.
12 Q. WAS SHE ABLE TO WALK?
13 A. NOT VERY MANY STEPS. SHE WAS -- USED A WHEEL CHAIR TO
14 GET AROUND. SHE COULD TAKE A FEW SHORT STEPS.
15 Q. AND DID YOU MAKE ARRANGEMENTS FOR HER CARE AFTER THAT
16 STROKE?
17 A. YES, I DID.
18 Q. AND WHERE WAS THOSE ARRANGEMENTS MADE?
19 A. ORIGINALLY AFTER SHE LEFT THE HOSPITAL SHE WENT TO THE
20 WESTERN REHABILITATION HOSPITAL. I BELIEVE THIS WAS A STAY
21 OF ABOUT SIX WEEKS AND THEN WAS TRANSFERRED TO THE SANDY
22 REGIONAL CARE CENTER WHERE SHE HAD LIVED THEN.
23 Q. WAS THAT IN 1990, DO YOU THINK?
24 A. IT WAS JANUARY OF 1991 THAT SHE WAS TRANSFERRED TO SANDY
25 REGIONAL.
1 Q. THAT'S A LONG-TERM CARE FACILITY?
2 A. THAT'S CORRECT.
3 Q. AND YOU RESIDE I THINK -- HOW FAR DO YOU RESIDE FROM THAT
4 FACILITY?
5 A. IT WAS ABOUT 15 MINUTES ON THE FREEWAY.
6 Q. OKAY. HAD YOUR MOTHER SUFFERED OR HAD SHE HAD ANY OTHER
7 SERIOUS MEDICAL PROBLEMS PRIOR TO THIS STROKE?
8 A. SHE HAD HAD STOMACH ULCERS SOME YEARS BEFORE AND HAD HAD
9 PART OF HER STOMACH REMOVED AND SHE HAD HAD SOME BACK
10 SURGERY.
11 Q. WHEN DID THAT OCCUR, DO YOU KNOW?
12 A. LET'S SEE I THINK THE BACK SURGERY -- I DON'T RECALL FOR
13 SURE. IT WAS EITHER 1984 OR 1986. I THINK IT WAS 1984.
14 Q. AFTER MOVING HER TO THE SANDY REGIONAL HOSPITAL OR CARE
15 CENTER, EXCUSE ME, DID YOU HAVE OCCASION TO WITH HER ON A
16 REGULAR BASIS?
17 A. YES, I DID.
18 Q. DID YOU HAVE OCCASION TO PROVIDE FOR MEDICAL CARE FOR
19 HER?
20 A. YES, I DID.
21 Q. AND WHO DID YOU HAVE -- WHO DID YOU EMPLOY TO PROVIDE HER
22 MEDICAL CARE?
23 A. WHEN MOM FIRST WAS AT SANDY REGIONAL I TOOK HER TO SEE
24 HER PRIVATE PHYSICIAN SHE HAD SEEN BEFORE DR. SARAH JANE
25 ANDERSON FOR A SHORT PERIOD OF TIME AND THEN DR. ANDERSON
1 WENT TO THE UNIVERSITY TO WORK IN THE LAST I THINK TWO OR
2 THREE OR FOUR YEARS IT WAS DR. RACHEL STUBBS THAT CARED FOR
3 HER AND I TOOK MOM TO SEE DR. STUBBS IN HER OWN OFFICE.
4 Q. HOW OFTEN WOULD YOU TAKE HER TO SEE DR. STUBBS?
5 A. EVERY 60 DAYS.
6 Q. EXCUSE ME, YOUR HONOR I'VE GOT TO GET MY GLASSES.
7 CAN YOU TELL US, DID YOUR MOTHER FROM THE TIME PERIOD
8 GOING UP FROM 1990 WHEN SHE WAS IN THE CARE CENTER -- OR 1991
9 FROM HER PLACEMENT IN THE CARE CENTER UP UNTIL NOVEMBER OF --
10 EXCUSE ME DECEMBER OF 1987 (SIC) DID SHE RESIDE CONTINUOUSLY
11 AT THE CARE CENTER?
12 A. NOW I'M MIXED UP ON THE DATES, MR. WILSON.
13 Q. PARDON ME?
14 A. I DIDN'T FOLLOW YOU ON THE DATES. I THOUGHT YOU SAID '95
15 TO '87.
16 Q. EXCUSE ME. I'M SORRY. 1991 I THINK YOU SAID SHE WENT
17 INTO THE CARE CENTER AND DID SHE CONTINUE TO RESIDE THERE UP
18 UNTIL THE TIME SHE WENT TO THE GEROPSYCH UNIT AT THE DAVIS
19 HOSPITAL?
20 A. YES, SHE DID.
21 Q. CAN YOU TELL US IN TERMS OF WHAT HER AGE WAS AT THAT
22 TIME?
23 A. AT THE TIME SHE WENT TO THE GEROPSYCH UNIT?
24 Q. YES.
25 A. SHE WAS 72.
1 Q. OKAY. SO IF MY MATH IS CORRECT SHE OCCURRED THIS STROKE
2 BACK WHEN SHE WAS ABOUT 67, 67, 68?
3 A. SEE, MY MATH ISN'T WORKING VERY WELL.
4 THE COURT: MR. WILSON, YOU NEED TO PICK UP THE PACE
5 JUST A LITTLE IF WE COULD.
6 THE WITNESS: I BELIEVE THAT WAS CORRECT.
7 MR. WILSON: I'LL TRY, YOUR HONOR.
8 THE COURT: ALL RIGHT.
9 Q. (BY MR. WILSON) CAN YOU DESCRIBE FOR US WHAT HER
10 CONDITION WAS AT THE CARE CENTER AS FAR AS HER PHYSICAL
11 CONDITION?
12 A. SHE STAYED PRETTY MUCH THE SAME THE YEARS THAT SHE WAS
13 THERE, CONTINUED WITH THE LEFT-SIDED WEAKNESS AND USED THE
14 WHEELCHAIR TO GET AROUND. AND I'D TAKE HER TO THE DOCTOR BY
15 MYSELF, USE HER WHEELCHAIR FOR TRANSPORT BUT TAKE HER IN MY
16 PERSONAL VEHICLE.
17 Q. CAN YOU TELL ME WHETHER OR NOT SHE HAD ANY COMPLAINTS
18 RELATIVE TO PAIN?
19 A. OVER THE YEARS MOM FREQUENTLY COMPLAINED. SHE COMPLAINED
20 OF HEADACHE A FAIR AMOUNT, EVEN WHEN I WAS YOUNG. AND IT WAS
21 KIND OF -- MY FAMILY OFTENTIMES FELT LIKE IT WAS MORE OF A
22 HABIT THAT SHE COMPLAINED AND ATTENTION-SEEKING BEHAVIOR, SHE
23 HAD BEEN WIDOWED FOR ABOUT 20 YEARS AND WAS LONELY.
24 Q. OKAY. IN TERMS OF HER COMPLAINTS OF PAIN, WERE THEY
25 SPECIFIC TO ANY PART OF HER BODY?
1 A. SHE COMPLAINED OF HER HEADACHE AND AT TIMES SHE
2 COMPLAINED TO THE BACK PAIN RELATED TO THE BACK SURGERY SHE
3 PREVIOUSLY HAD.
4 Q. DO YOU KNOW WHETHER SHE WAS PRESCRIBED ANY MEDICATION FOR
5 THAT PAIN?
6 A. YES. SHE WAS GIVEN EXTRA STRENGTH TYLENOL IN THE NURSING
7 HOME AND THERE WAS ALSO HYPHIN OR HYDROCODONE ORDERED.
8 Q. ALL RIGHT. DID YOU HAVE OCCASION TO SEE -- OR DID YOU
9 HAVE OCCASION TO EXPERIENCE PERSONALLY WHEN YOU WERE AT THE
10 CARE CENTER HER COMPLAINS RELATED TO PAIN?
11 A. AT TIMES.
12 Q. DID YOU DO ANYTHING ABOUT THAT?
13 A. WE TALKED TO THE NURSES AND ASKED THEM TO MEDICATE HER IF
14 SHE WAS IN PAIN.
15 Q. NOW, IT'S TRUE, IS IT NOT, THAT SHE WAS ALSO GIVEN A
16 CALCIUM PILL AS A PLACEBO FOR PAIN, IS THAT CORRECT?
17 A. YES, THAT'S CORRECT.
18 Q. AND HOW -- WERE YOU PRESENT ON ANY OCCASIONS WHEN THAT
19 PLACEBO WAS ADMINISTERED TO HER?
20 A. AT TIMES, YES.
21 Q. DO YOU KNOW WHETHER OR NOT THERE WAS ANY FURTHER
22 INQUIRIES MADE OF HER AFTER RECEIVING THE PLACEBO AS TO HOW
23 SHE WAS FEELING?
24 A. YES. WE'D ASK HER HOW SHE FELT AND SHE OFTENTIMES
25 RELATED THAT SHE HAD RELIEF FROM HER HEADACHE OR WHATEVER THE
1 COMPLAINT WAS THAT SHE HAD AFTER SHE RECEIVED THE CALCIUM.
2 Q. WAS THERE -- DID YOU YOURSELF HAVE THE ABILITY TO
3 DETERMINE WHEN IT WAS INDEED PAIN OR WHEN IT WAS NOT PAIN?
4 A. I THINK WE COULD SEE VISUALLY THE EXPRESSION ON MOM'S
5 FACE WHETHER SHE WAS IN AGONY OR IT APPEARED TO BE MORE THE
6 ATTENTION-SEEKING BEHAVIOR I HAD PREVIOUSLY MENTIONED.
7 Q. SHE SUFFER FROM ANY FORM OF DEMENTIA?
8 A. I THINK SHE HAD CONFUSION AT TIMES.
9 Q. OKAY. OTHER THAN THE PAIN THAT SHE SUFFERED FROM, WAS
10 THERE ANY OTHER PHYSICAL PROBLEM THAT SHE EXPERIENCED WHILE
11 AT THE FACILITY?
12 A. YES. SHE HAD FREQUENT URINARY TRACT INFECTIONS AND ALSO
13 HAD CHRONICALLY LOW SODIUM IN HER BLOOD.
14 Q. WAS SHE TREATED FOR THOSE URINARY INFECTIONS?
15 A. YES, SHE WAS.
16 Q. IN TERMS OF THE LOW SODIUM, DO YOU KNOW WHETHER THERE WAS
17 ANY TREATMENT THAT WAS RENDERED IN RESPECT TO THAT?
18 A. YES. THE PROBLEM WITH LOW SODIUM IT STARTED SEVERAL
19 YEARS BEFORE, I BELIEVE IN THE LATE '80S AND WE WENT TO
20 SEVERAL DOCTORS AND COULD NEVER REALLY IDENTIFY ANY REASON
21 THAT SHE WOULD HAVE THIS CHRONICALLY LOW SODIUM. THE DOCTORS
22 WOULD CHANGE HER BLOOD PRESSURE MEDICINE AND CHECK HER
23 KIDNEYS AND WHATNOT AND COULD NEVER FIND A REASON. AND THE
24 ONLY WAY WE COULD KEEP HER SODIUM SOMEWHAT IN NORMAL RANGE
25 WAS A MODERATE FLUID RESTRICTION.
1 Q. WAS THERE A TIME THAT HER CONFUSION INCREASED OR IN TERMS
2 OF WHEN SHE WAS AT THE NURSING CARE FACILITY?
3 A. I RECALL A COUPLE OF EPISODES WHEN THE BLADDER INFECTION
4 WAS BAD ENOUGH THAT SHE GOT SOME CONFUSION, BUT SHORTLY AFTER
5 THE ANTIBIOTICS WERE STARTED, THAT WOULD RESOLVE.
6 Q. WAS THERE A TIME THAT CAME WHERE SHE SEEMED TO BE ACTING
7 OUT MORE AT THE CARE CENTER?
8 A. YES, THERE WAS.
9 Q. AND CAN YOU TELL US WHEN THAT WAS?
10 A. THAT WAS MAYBE IN LET'S SEE IT WOULD HAVE BEEN MID '94 OR
11 EARLY '94, SHE HAD BEEN RESIDING IN THE REGULAR LONG-TERM
12 CARE PORTION OF THE FACILITY AND BEHAVED WHERE SHE CALLED OUT
13 AND THE ATTENTION-SEEKING BEHAVIORS OF HOLLERING AND NEEDING
14 A LOT OF HELP AND FREQUENTLY NEEDING TO GO TO THE BATHROOM
15 BECAUSE OF THE STOMACH SURGERY SHE HAD. IT GOT TO BE A
16 LITTLE TOO MUCH FOR THE NURSING STAFF ON THE REGULAR AREA OF
17 THE CARE CENTER TO CARE FOR HER AND FELT LIKE SHE WOULD
18 BENEFIT FROM PLACEMENT IN WHAT SANDY REGIONAL CALLED THE
19 SPECIAL NEEDS UNIT, FELT THE NURSING STAFF BACK THERE WAS
20 BETTER TRAINED TO HANDLE PATIENTS WITH DIFFICULT BEHAVIORS.
21 Q. SO SHE WAS MOVED TO ANOTHER SECTION IN THE CARE CENTER?
22 A. YES. IT WAS JUST -- THERE WAS A DOOR BETWEEN THE TWO
23 AREAS AND THAT'S WHERE SHE WAS MOVED TO A SPECIAL NEEDS UNIT.
24 Q. DID THE CONFUSION PROBLEMS AND THE ACTING OUT CONTINUE?
25 A. YES. I THINK SO, BUT I THINK THE STAFF BACK THERE
1 HANDLED IT BETTER.
2 Q. OKAY. DID THERE COME A TIME, THOUGH, THAT IT WAS
3 SUGGESTED THAT SHE SHOULD BE TREATED AT THE GEROPSYCH UNIT AT
4 THE DAVIS HOSPITAL?
5 A. YES. IT WAS ABOUT THE MIDDLE OF 1995 -- EXCUSE ME, THE
6 MIDDLE OF DECEMBER 1995 AT ONE OF THE QUARTERLY INNER -- I
7 CAN'T REMEMBER THE EXACT NAME, THE INTERDEPARTMENTAL TEAM
8 MEETINGS WHERE SEVERAL SPECIALISTS THROUGHOUT THE NURSING
9 HOME WOULD GET TOGETHER AND REVIEW MOM'S CARE, I WAS
10 APPROACHED AT THAT MEETING TO -- THAT WE NEEDED TO MOVE MOM,
11 WE NEEDED TO DO SOMETHING, THAT HER BEHAVIOR WAS SUCH THAT
12 THE NURSING STAFF EVEN IN THE SPECIAL NEEDS UNIT WAS HAVING
13 TROUBLE DEALING WITH IT. AND WE EITHER NEEDED TO MOVE HER TO
14 A DIFFERENT NURSING FACILITY OR TO A GERIATRIC NURSING
15 FACILITY.
16 Q. AND THAT TOOK PLACE, DID IT NOT?
17 A. YES, THAT'S CORRECT.
18 Q. WAS THERE A PLAN TO PLACE HER BACK INTO THE UNIT AFTER
19 GOING TO THE GEROPSYCH?
20 A. YES, THERE WAS. WE WERE TOLD THAT THE FACILITY WAS
21 DESIGNED FOR SHORT-TERM MEDICATION MANAGEMENT AND ADJUSTMENT
22 AND IT WOULD BE TWO- TO THREE-WEEK STAY AND SHE WOULD BE BACK
23 TO SANDY REGIONAL.
24 Q. DID YOU SPEAK YOURSELF WITH THE PEOPLE AT THE GEROPSYCH
25 UNIT?
1 A. YES, THERE WAS A SOCIAL WORKER. I DON'T RECALL THE NAME.
2 Q. DID YOU PROVIDE THE INFORMATION THEN AS IT RELATED TO
3 YOUR MOTHER TO THAT SOCIAL WORKER?
4 A. YES. AND THEY BROUGHT INFORMATION FROM THE NURSING STAFF
5 ALSO.
6 Q. SO WHEN DID THAT TRANSFER TO THE GEROPSYCH UNIT AT THE
7 DAVIS HOSPITAL TAKE PLACE?
8 A. DECEMBER 28TH, 1995.
9 Q. AGAIN, I NEED YOU TO DESCRIBE WHAT HER PHYSICAL CONDITION
10 WAS -- HER PHYSICAL CONDITION WAS AT THE TIME THAT SHE WAS
11 TRANSFERRED TO THE GEROPSYCH UNIT?
12 A. SHE WAS PRETTY MUCH ABOUT THE SAME THE ENTIRE YEAR SHE
13 WAS AT SANDY REGIONAL, AND THAT WAS THE WAY SHE WAS WHEN I
14 TRANSFERRED HER TO THE GEROPSYCH UNIT. I WAS ABLE TO TAKE
15 HER IN A WHEELCHAIR AND TRANSFER HER INTO THE CAR. I DROVE
16 HER UP TO LAYTON FROM SANDY, GOT HER OUT OF THE CAR. SHE HAD
17 SOME STRENGTH BUT WAS, YOU KNOW, UNABLE TO WALK ON HER OWN.
18 Q. OKAY. FROM A MENTAL STANDPOINT, THOUGH, SHE HAD -- SHE
19 WAS MORE CONFUSED I ASSUME AT THAT TIME?
20 A. SHE WAS A LITTLE CONFUSED. I EXPLAINED TO HER ON THE WAY
21 UP WHAT WE WERE DOING AND THE MEDICATIONS WOULD BE ADJUSTED
22 TO IMPROVE THE QUALITY OF HER LIFE WAS THE WAY THE PROGRAM
23 HAD BEEN EXPLAINED TO US, AND SHE SEEMED OKAY WITH THAT.
24 Q. DID SHE SEEM TO COMPREHEND THAT?
25 A. YES.
1 Q. HOW DID SHE -- HOW DID SHE ACT WHEN SHE GOT TO THE UNIT
2 ITSELF?
3 A. SHE SEEMED FINE. SHE WAS ABLE TO SIGN HER OWN ADMISSION
4 PAPERS AND ANSWER THE QUESTIONS DURING THE INITIAL
5 INTERACTION WITH THE NURSING STAFF.
6 Q. OKAY. DID YOU HAVE ANY CONTACT WITH THE DEFENDANT AT
7 THAT TIME?
8 A. NO, I DID NOT.
9 Q. HOW LONG WERE YOU AT THE GEROPSYCH UNIT BEFORE YOU LEFT?
10 A. THAT PARTICULAR DAY?
11 Q. UH-HUH.
12 A. IT WAS PROBABLY ABOUT FOUR HOURS, MAYBE FROM 1:30 TO 530
13 OR 2 TO 6, SOMETHING LIKE THAT.
14 Q. DURING THAT TIME FRAME, WAS THERE ANY CONTACT BETWEEN ANY
15 PHYSICIANS OR NURSING STAFF WITH YOUR MOTHER?
16 A. ONLY THE NURSING STAFF THAT I RECALL.
17 Q. WAS SHE GIVEN ANY FORM OF MEDICATIONS OR ANYTHING OF THAT
18 SORT?
19 A. I DON'T RECALL ANYTHING BEING GIVEN WHILE I WAS THERE.
20 Q. OKAY. DO YOU KNOW WHETHER OR NOT HER MEDICAL HISTORY
21 FROM THE CARE CENTER WAS TAKEN UP TO THE GEROPSYCH UNIT?
22 A. YES, IT WAS. I HAD AN ENVELOPE WITH HER INFORMATION.
23 Q. NOW, DID YOU CONTINUE TO VISIT WITH YOUR MOTHER AFTER SHE
24 WAS ADMITTED TO THE GEROPSYCH UNIT?
25 A. YES, I DID.
1 Q. AND CAN YOU TELL ME ON HOW MANY OCCASIONS YOU WOULD HAVE
2 VISITED WITH HER BETWEEN THE TIME PERIOD WHERE SHE WAS
3 ADMITTED AND THE DATE OF HER DEATH?
4 A. IT WAS FOUR OR FIVE TIMES.
5 Q. OKAY. AND WAS THERE A CERTAIN TIME OF DAY THAT YOU WOULD
6 GO UP AND SO YOUR MOTHER?
7 A. IT WOULD HAVE BEEN IN THE EVENING ON THE WEEKDAYS AND --
8 BECAUSE I WORKED, AND DURING THE DAY ON THE WEEKENDS.
9 Q. SHE WENT IN ON I THINK YOU SAID THE 28TH?
10 A. YES.
11 Q. IF YOU WOULD, CAN YOU DESCRIBE FOR US, AS YOU VISITED
12 WITH YOUR MOTHER ANY CHANGES IN HER BEHAVIOR OR HER PHYSICAL
13 CONDITION THAT YOU NOTICED?
14 A. SHE GOT PROGRESSIVELY SLEEPIER. EVERY TIME I SAW HER SHE
15 SEEMED MORE SLEEPY AND WEAK AND DIFFICULT TO COMMUNICATE WITH
16 THAN THEY HAD BEEN THE PREVIOUS TIME.
17 Q. DID YOU MAKE ANY INQUIRY RELATIVE TO THAT BEHAVIOR THAT
18 YOU OBSERVED?
19 A. YES, I DID.
20 Q. AND WHAT WAS THE INQUIRY -- WHO DID YOU MAKE THE INQUIRY
21 TO?
22 A. I ASKED THE NURSING STAFF WHAT MEDICATION SHE WAS
23 RECEIVING THAT WAS CAUSING HER TO BE SO SLEEPY AND THEY TOLD
24 ME IT WAS RESPERIDAL.
25 Q. WERE YOU AWARE OF ANY OTHER MEDICATIONS THAT SHE WAS
1 RECEIVING AT THAT TIME?
2 A. NO. WHENEVER I ASKED WHY SHE WAS SO SLEEPY, THE NURSES
3 ALWAYS TOLD ME THE RESPERIDAL AND SHE WOULD GRADUALLY GET
4 USED TO THE DOSAGE AND NOT BE SO SLEEPY.
5 Q. SO YOU CONTINUED TO VISIT WITH HER?
6 A. YES.
7 Q. DID YOU CONTINUE TO OBSERVE ANY BEHAVIORAL CHANGES?
8 A. WELL, JUST LIKE I SAID, SHE HAD GOTTEN PROGRESSIVELY MORE
9 SLEEPY AS THE DAYS WENT ON.
10 Q. CAN YOU RECALL SOME OF THE LAST VISITS THAT YOU MADE WITH
11 HER JUST PRIOR TO HER DEATH?
12 A. SHE PASSIONED A PASSED AWAY ON A SUNDAY AND I WAS THERE
13 WITH MY SON ON A SATURDAY AND SHE WAS VERY VERY SLEEPY AND
14 HARD TO AROUSE.
15 Q. DO YOU REMEMBER TALKING WITH HER ON THAT OCCASION?
16 A. WITH DIFFICULTY. HARD TO YOU KNOW HARD TO AROUSE AND
17 HARD TO GET INFORMATION OUT. SHE WAS IN BED.
18 Q. AND WHAT TIME OF DAY WAS THAT?
19 A. I THINK IT WOULD HAVE BEEN EARLY AFTERNOON.
20 Q. DID YOU HAVE ANY CONVERSATIONS WITH THE DEFENDANT ON
21 EITHER SATURDAY OR SUNDAY OF THE FOLLOWING DAY?
22 A. SUNDAY.
23 Q. OKAY. DO YOU RECALL APPROXIMATELY WHAT TIME THAT TOOK
24 PLACE?
25 A. IT WAS AROUND 8 P.M.
1 Q. AND WHO WAS PRESENT AT THAT MEETING?
2 A. MY BROTHER AND MY SISTER AND HER HUSBAND AND THEIR
3 CHILDREN AND MY HUSBAND AND MY CHILDREN.
4 Q. AND WHERE DID THE MEETING TAKE PLACE?
5 A. I'M SORRY, MEL. I THINK I MISUNDERSTOOD. THE MEETING
6 WHERE WE DISCUSSED WITH DR. WEITZEL WAS JUST MY HUSBAND AND
7 MYSELF AND DR. WEITZEL IN MY MOTHER'S ROOM OFF TO THE SIDE.
8 Q. OKAY. BUT YOUR BROTHER-IN-LAW AND SISTER WERE THERE?
9 A. THEY WERE ALL THERE AROUND THE BEDSIDE AROUND MY MOTHER.
10 Q. AND YOU WERE OFF TO THE SIDE WITH THE DOCTOR?
11 A. THAT'S CORRECT.
12 Q. OKAY. SO THEY DID NOT PARTICIPATE IN THE DISCUSSION?
13 A. THAT'S CORRECT.
14 Q. WHAT IF ANYTHING WAS SAID TO YOU AT THAT TIME KAREN IN
15 REGARDS TO YOUR MOTHER'S CONDITION?
16 A. DR. WEITZEL SAID WHATEVER HAD HAPPENED WAS IRREVERSIBLE
17 AND SHE WASN'T EXPECTED TO SURVIVE. AND I ASKED HIM WHAT
18 THERE WAS THAT WE COULD DO FOR HER AND HE SAID WE CAN GIVE
19 HER MORPHINE AND HASTEN THE INEVITABLE.
20 Q. WE COULD GIVE HER MORPHINE AND HASTEN THE INEVITABLE?
21 A. YES.
22 Q. IN TERMS OF THE CONDITION THAT YOU OBSERVED YOUR MOTHER
23 IN AT THAT TIME, DID YOU PERCEIVE THAT SHE WAS SUFFERING FROM
24 ANY PAIN?
25 A. SHE WAS PRETTY MUCH OUT OF IT, UNRESPONSIVE, GURGLING.
1 Q. DID HIS -- DID THE INDICATION OF GIVING HER MORPHINE
2 CAUSE YOU ANY CONCERN AT THAT TIME?
3 A. NO, BECAUSE I KNEW AT THE END OF PEOPLE'S LIFE THAT
4 HAPPENS.
5 Q. OKAY. DID HE GET SPECIFIC AS TO WHAT THE PROBLEM WAS
6 THAT WAS CAUSING HER DEATH?
7 A. HE HADN'T SAID ANYTHING. THE NURSING STAFF HAD TOLD ME
8 THAT MOM EITHER HAD HAD A SEIZURE OR A STROKE.
9 Q. DID YOU HAVE ANY INFORMATION TO SUGGEST TO YOU OTHERWISE?
10 A. NO, I DID NOT.
11 Q. SO YOU ACCEPTED THAT, I TAKE IT?
12 A. YES, WE DID.
13 Q. NOW THAT OCCURRED ON THE 7TH?
14 A. JANUARY 7TH, YES, 1996.
15 Q. DID YOU SEE YOUR MOTHER THE FOLLOWING DAY?
16 A. I'M SORRY, THE DAY AFTER SHE DIED?
17 Q. NO. ON THE 8TH?
18 A. SHE DIED ON THE NIGHT OF THE 7TH.
19 Q. WHEN WERE YOU NOTIFIED THAT SHE HAD PASSED AWAY?
20 A. WE WERE --
21 Q. WAS THAT ON THE 7TH?
22 A. WE WERE PRESENT ON THE 7TH. IT WAS AROUND 11:30 P.M.
23 Q. SO YOU WERE PRESENT AT THE TIME SHE PASSED AWAY?
24 A. YES.
25 Q. DO YOU KNOW WHETHER OR NOT SHE RECEIVED ANY INJECTIONS OR
1 ANYTHING JUST PREVIOUS TO THAT TIME?
2 A. YES, SHE DID.
3 Q. DO YOU RECALL WHEN SHE RECEIVED THOSE INJECTIONS?
4 A. AFTER MY DISCUSSION WITH DR. WEITZEL AND HE SAID THAT WE
5 COULD GIVE HER MORPHINE TO HASTEN THE INEVITABLE SHE WITHIN
6 JUST A FEW MINUTES THE NURSE CAME AND GAVE HER AN INJECTION
7 OF MORPHINE. AND THREE HOURS LATER, WHICH WOULD HAVE BEEN
8 AROUND 11 O'CLOCK, SHE RECEIVED ANOTHER INJECTION.
9 Q. AND SHE PASSED AWAY ABOUT A HALF HOUR AFTER THAT?
10 A. THAT'S CORRECT.
11 Q. DID YOU EVER HAVE ANY FURTHER CONVERSATION WITH THE
12 DEFENDANT SUBSEQUENT TO YOUR MOTHER'S DEATH?
13 A. NO, I DID NOT.
14 MR. WILSON: I DON'T THINK I HAVE ANY FURTHER
15 QUESTIONS AT THIS TIME.
16 THE COURT: CROSS-EXAMINE. WILL THAT BE YOU,
17 MR. BUGDEN?
18 MR. BUGDEN: YES, YOUR HONOR. I NEED JUST A MOMENT
19 BUT I WILL BE CROSS-EXAMINING.
20 MAY I APPROACH THE WITNESS, YOUR HONOR?
21 THE COURT: YOU MAY.
22 CROSS-EXAMINATION
23 BY MR. BUGDEN:
24 Q. MA'AM, MY NAME IS WALTER BUGDEN AND I'M ONE OF THE
25 LAWYERS THAT REPRESENTS DR. WEITZEL. HOW DO YOU DO?
1 A. YES. THANK YOU. FINE.
2 Q. I'M GOING TO SHOW YOU SOME DOCUMENTS AND OCCASIONALLY I'M
3 GOING TO ASK YOU TO REFER TO THEM. IS THAT ALL RIGHT?
4 A. OKAY. UH-HUH.
5 Q. AND I'M JUST GOING TO TRY AND FAMILIARIZE WITH YOU OF HOW
6 I'M GOING TO POINT THINGS OUT TO YOU. I MAY REFER TO A
7 NUMBER LIKE THAT.
8 A. UH-HUH.
9 Q. OR -- AND PROBABLY THE EASIEST WAY FOR ME TO COMMUNICATE
10 WITH YOU IS TO TALK ABOUT THIS LARGER NUMBER IN THE
11 RIGHT-HAND CORNER.
12 A. OKAY.
13 Q. MA'AM, I UNDERSTAND THAT YOU'VE BEEN A SURGICAL NURSE FOR
14 YOUR NURSING CAREER; IS THAT RIGHT?
15 A. THAT'S CORRECT.
16 Q. NOW, YOUR MOTHER SUFFERED HER STROKE IN 1990; IS THAT
17 RIGHT?
18 A. THAT'S CORRECT, THANKSGIVING DAY.
19 Q. AND THAT THEN LEFT HER WITH LEFT-SIDE WEAKNESS, AM I
20 RIGHT?
21 A. YES.
22 Q. AND THAT THAT HE ESSENTIALLY FORCED HER TO -- HER
23 AMBULATION -- SHE COULDN'T REALLY GET AROUND, SHE NEEDED A
24 WHEELCHAIR, AM I RIGHT?
25 A. THAT'S CORRECT.
1 Q. AND THEN YOU'VE TOLD US THAT APPARENTLY THERE WAS A
2 CHANGE IN HER MENTAL STATUS -- OBVIOUSLY AFTER THE STROKE,
3 BUT OVER THE NEXT SEVERAL YEARS THERE WERE CHANGES IN HER
4 MENTAL STATUS THAT REQUIRED CHANGES IN HER CARE FACILITY
5 ACCOMMODATIONS, AM I RIGHT?
6 A. THAT'S CORRECT.
7 Q. AND AT LEAST INITIALLY AFTER THE STROKE I MEAN SHE WENT
8 TO THE SANDY REGIONAL RIGHT AWAY?
9 A. NO. SHE WENT TO THE WESTERN REHABILITATION HOSPITAL FOR
10 SIX WEEKS.
11 Q. AND THEN DID SHE GO TO THE SANDY REGIONAL?
12 A. SANDY REGIONAL. SHE WAS ON THE MEDICARE WING FOR ABOUT
13 THREE WEEKS INITIALLY AT SANDY REGIONAL WHERE THEY GET A
14 LITTLE MORE CARE THAN THE GENERAL AREA OF THE NURSING HOME,
15 AND THEN SHE WENT TO THE GENERAL AREA OF THE NURSING HOME,
16 THE LONG-TERM CARE.
17 Q. THEN SHE WENT TO A LONG-TERM CARE?
18 A. IT'S ALL IN THE SAME FACILITY. IT'S JUST A DIFFERENT
19 AREA IN THE FACILITY.
20 Q. THANK YOU.
21 A. UH-HUH.
22 Q. AND SHE THEN WAS IN THE LONG-TERM CARE FACILITY OF THE
23 SANDY REGIONAL FOR ABOUT HOW LONG?
24 A. LET'S SEE, IT WOULD HAVE BEEN PROBABLY ABOUT THREE YEARS,
25 THREE AND A HALF YEARS.
1 Q. AND THEN THERE WAS A DECLINE IN HER MENTAL STATUS SUCH
2 THAT THE FOLKS THE INTERDISCIPLINARY STAFF, WHATEVER, BUT THE
3 FOLKS, PEOPLE AT SANDY REGIONAL TOLD YOU THAT IN ORDER TO
4 MANAGE YOUR MOTHER'S SITUATION THAT SHE NEED TO BE IN WHAT
5 THEY CALLED WAS A SPECIAL NEEDS UNIT, AM I RIGHT?
6 A. THAT'S CORRECT.
7 Q. AND THAT WAS REALLY A UNIT FOR PEOPLE WITH ALZHEIMER?
8 A. NOT ONLY ALZHEIMER PATIENTS. THERE WERE PATIENTS WITH
9 BEHAVIOR PROBLEMS. IT WAS A UNIT FOR PATIENTS WITH BEHAVIOR
10 PROBLEMS.
11 Q. AND UNFORTUNATELY, THAT WAS YOUR MOTHER'S SITUATION WAS
12 THAT SHE HAD BEHAVIORAL PROBLEMS THAT COULDN'T BE HANDLED
13 JUST IN THE LONG-TERM CARE FACILITY?
14 A. RIGHT.
15 Q. AND SO THEY HAD TO PUT HER IN THIS SORT OF GREATER
16 ATTENTION UNIT?
17 A. THE STAFF -- THEY FELT THE STAFF WAS BETTER EQUIPPED TO
18 HANDLE DIFFICULT BEHAVIORS.
19 Q. AND THEN IN TERMS OF THE MEDICAL CONDITIONS THAT YOUR MOM
20 HAD, OF COURSE SHE HAD THE STROKE THAT PRECIPITATED THIS
21 HOSPITAL OR THIS LONG-TERM CARE FACILITY, DID SHE ALSO HAVE
22 FALLS IN THE NURSING HOME?
23 A. YES, SHE DID.
24 Q. DID SHE FRACTURE HER PELVIC BONE?
25 A. YES, SHE DID.
1 Q. AND THEN I BELIEVE YOU'VE TOLD US THAT YOUR MOM
2 FREQUENTLY REPORTED THAT SHE HAD DIFFERENT PAINS, AM I RIGHT?
3 A. YES.
4 Q. SHE FREQUENTLY REPORTED, FOR EXAMPLE, THAT SHE HAD
5 HEADACHES?
6 A. YES, AND HAD DONE THAT ALL OF HER LIFE.
7 Q. I WANT TO LOOK FOR JUST A LITTLE WHILE, THOUGH,
8 POST-STROKE, POST-1990 STROKE. THE COMPLAINTS THAT SHE HAD
9 OF DISCOMFORT OR PAIN HAD TO DO WITH BOTH HER LOWER BACK, AM
10 I RIGHT?
11 A. YES.
12 Q. AND THEN THE HEADACHE SITUATION?
13 A. YES.
14 Q. NOW, IN 1994 YOUR MOTHER HAD TO BE RUSHED TO THE ALTA
15 VIEW HOSPITAL, DO YOU REMEMBER THAT?
16 A. AFTER REVIEW OF THE RECORDS I RECALL --
17 Q. THANK YOU.
18 A. -- THE DETAILS OF THAT VISIT.
19 Q. I'M GOING TO ASK YOU TO TURN TO SLIDE NUMBER TWO I, THINK
20 IT IS --
21 MR. BUGDEN: AND YOUR HONOR, THIS IS 4A WHICH HAS
22 BEEN RECEIVED AND IT'S NURSING HOME RECORD 554.
23 Q. (BY MR. BUGDEN) AND YOUR MOTHER WAS -- HAD TO BE TAKEN
24 TO THE HOSPITAL BECAUSE SHE WAS COMPLAINING OF CHEST PAIN IN
25 HER NECK -- CHEST PAIN AND PAIN IN HER NECK AND IN HER ARMS,
1 IS THAT RIGHT?
2 A. I ONLY RECALL THAT FROM REVIEW OF THE MEDICAL RECORDS
3 THAT I RECENTLY DID.
4 Q. OH, THAT'S FINE. THAT'S HELPFUL FOR US.
5 A. OKAY.
6 Q. LET'S TALK ABOUT MEMORY, IN FACT, FOR JUST A MOMENT.
7 YOU'RE A NURSE AND YOU'RE USED TO CHARTING THINGS, AM I
8 RIGHT?
9 A. WELL, THE CHARTING THAT'S DONE IN THE OPERATING ROOM IS
10 ENTIRELY DIFFERENT THEN CHARTING THAT'S DONE ON THE NURSING
11 UNITS.
12 Q. WELL, HERE I'M GOING TO ASK YOU QUESTIONS ABOUT SOMETHING
13 THAT HAPPENED IN 1994. WOULD YOU GENERALLY AGREE THAT YOUR
14 MEMORY TODAY SURELY ISN'T AS SHARP ABOUT THIS EVENT AS IT
15 MIGHT HAVE BEEN IN 1994?
16 A. THAT'S CORRECT.
17 Q. AND WOULD YOU AGREE THAT PEOPLE IN THE HEALTHCARE
18 PROFESSION ARE TRAINED TO DO CHARTING TO TRY TO REPORT
19 THINGS, TO WRITE THINGS DOWN WHEN THOSE EVENTS ARE STILL
20 RELATIVELY FRESH IN THEIR MEMORY?
21 A. THAT'S CORRECT.
22 Q. AND IN A CASE JUST LIKE THIS WHERE WE'RE TRYING TO
23 REMEMBER SOMETHING THAT HAPPENED EIGHT YEARS AGO IN 1994, IT
24 IS HELPFUL TO HAVE A MEDICAL RECORD THAT WAS PREPARED
25 CONTEMPORANEOUSLY WITH THE EVENT?
1 A. YES.
2 Q. IT HELPS TO REFRESH YOUR MEMORY, TOO?
3 A. YES, UH-HUH.
4 Q. SO THE QUESTION I JUST ASKED YOU WAS WHETHER OR NOT YOUR
5 MOM HAD TO BE TAKEN FROM THE NURSING HOME WITH COMPLAINTS OF
6 PAIN. AND DOES IT REFRESH YOUR MEMORY, IN FACT, SHE DID HAVE
7 THIS CHEST PAIN THAT WAS RADIATING DOWN INTO THE NECK AND
8 ARMS? I THINK IF YOU TURN TO PAGE 3, MRS. BRINGHURST. HAVE
9 YOU DONE THAT?
10 A. YES, UH-HUH.
11 Q. YOU'LL SEE THAT THAT'S WHAT I'M GOING TO FREQUENTLY DO AS
12 I ASK YOU SOME QUESTIONS, THAT I'LL FIRST SHOW YOU THE FIRST
13 PAGE IN A LARGER VERSION AND THEN WE CAN LOOK AT A BLOW UP
14 THAT'S EASIER TO READ.
15 A. OKAY.
16 Q. IT SAYS THAT THE PATIENT'S DAUGHTER SAID THAT SHE WAS A
17 LITTLE BIT MORE CONFUSED THAN NORMAL, WOULD THAT BE YOU?
18 A. YES.
19 Q. THAT LIKELY WOULD HAVE BEEN YOU?
20 A. I THINK IT WOULD HAVE BEEN ME BUT I RECALL MY SISTER
21 BEING THERE ALSO.
22 Q. NOW, DOES IT ALSO COMPORT WITH YOUR MEMORY THAT, IN FACT,
23 THE HEADACHE WAS BAD ENOUGH THAT YOUR MOTHER WAS TREATED WITH
24 MORPHINE FOR HER HEADACHE?
25 A. I DON'T RECALL WITHOUT LOOKING AT THOSE RECORDS AGAIN
1 IF --
2 Q. WELL, LET'S DO THAT TOGETHER THEN.
3 A. -- IF SHE COMPLAINED OF HEADACHE THAT DAY.
4 Q. IF YOU LOOK AT THE NEXT PAGE, JUDGE, WHICH IS NURSING
5 HOME RECORD 555 THAT'S A LARGER VERSION AND I'M GOING TO ASK
6 YOU, MRS. BRINGHURST, TO TURN TO SLIDE OR PAGE 5.
7 A. OKAY.
8 Q. ARE YOU THERE?
9 A. YES.
10 Q. OKAY. AND AS YOU CAN SEE THE RECORD REFLECTS THAT YOUR
11 MOTHER RECEIVED SOME MEDICATIONS WHICH INCLUDED IN ADDITION
12 THE PATIENT RECEIVED INAPSINE, AM I PRONOUNCING THAT RIGHT?
13 A. YES.
14 Q. AND MORPHINE TITRATED TO PAIN. DO YOU SEE THAT?
15 A. YES, I DO.
16 Q. DOES THAT REFRESH YOUR MEMORY THAT YOUR MOM ACTUALLY
17 RECEIVED MORPHINE ON THAT OCCASION TO DEAL WITH HER PAIN
18 PROBLEM?
19 A. I'M ASSUMING SHE DID SINCE IT'S HERE. I STILL DON'T
20 RECALL ACTUALLY THE EVENT OCCURRING.
21 Q. CAN YOU REMEMBER THAT THE ER CONTACTED DR. STUBBS AND
22 DISCUSSED WITH DR. STUBBS THAT YOUR MOTHER'S PRESENTING
23 PROBLEM AT THAT TIME?
24 A. I DON'T RECALL THAT OCCURRING BUT I'M ASSUMING THEY DID
25 SINCE DR. STUBBS WAS HER PRIVATE PHYSICIAN AND THE ONLY
1 PHYSICIAN THAT CARED FOR HER ON A REGULAR BASIS.
2 Q. DO YOU RECALL -- IF YOU'LL TURN TO THE NEXT PAGE. DO YOU
3 RECALL ALSO DISCUSSING WITH THE PHYSICIAN THAT YOU ON BEHALF
4 OF YOUR MOTHER WAS NOT INTERESTED IN ANY AGGRESSIVE MANEUVERS
5 BECAUSE YOUR MOTHER HAD A LIVING WILL IN PLACE IN THE EVENT
6 THAT SHE SHOULD DETERIORATE?
7 A. SIMILAR TO THE LAST QUESTION, I DON'T RECALL THESE THINGS
8 SPECIFICALLY IN MY MEMORY. AND ACCORDING TO THIS, IT APPEARS
9 THAT I WAS NOT CONSULTED, THE WAY I'M READING THIS. IT
10 DOESN'T SAY THAT THEY TALKED TO THE FAMILY AT LEAST ON THIS
11 PAGE.
12 Q. OKAY. NOW, LET'S TALK FOR A MOMENT ABOUT SOME OF THE
13 BEHAVIORAL PROBLEMS THAT YOUR MOTHER HAD. YOU WERE AWARE IS
14 THAT OVER TIME YOUR MOTHER BECAME COMBATIVE, IS THAT RIGHT?
15 A. THE NURSES REPORTED THAT. I NEVER OBSERVED IT MYSELF.
16 Q. DO YOU HAVE ANY REASON TO DOUBT THE NURSES?
17 A. NO. JUST I NEVER OBSERVED IT MYSELF.
18 Q. OKAY. AND YOU'VE TOLD US THAT YOUR MOTHER HOLLERED FOR
19 ATTENTION. YOUR MOTHER, JUST GENERALLY SPEAKING, THROUGHOUT
20 THE LAST YEARS OF HER LIFE, SHE DID A LOT OF SCREAMING, ISN'T
21 THAT TRUE? LOUD -- LOUD -- SPEAKING IN A VERY LOUD VOICE.
22 A. WELL, SHE WAS HARD TO HEAR AND SHE WAS KIND OF A LOUD
23 PERSON ALL ALONG, ALL HER LIFE.
24 Q. DID YOU CONSIDER IN THE LAST FEW YEARS OF YOUR MOM'S
25 LIFE, PARTICULARLY IN 1995, DID YOU -- DID YOU BELIEVE THAT
1 YOUR MOTHER SUFFERED FROM DEMENTIA?
2 A. I DON'T -- I DON'T RECALL THAT I DID.
3 Q. YOU DIDN'T THINK OF IT THAT WAY?
4 A. NO. I DIDN'T THINK OF IT AS DEMENTIA.
5 Q. YOU JUST THOUGHT THAT SHE WAS SOMETIMES CONFUSED AND
6 SOMETIMES DISORIENTED?
7 A. YES.
8 Q. OKAY. AND BECAUSE -- BUT YOU DID RECOGNIZE THAT SHE
9 FREQUENTLY DID HAVE SOME PERIODS OF CONFUSION, IS THAT RIGHT?
10 A. I DON'T KNOW IF I'D SAY FREQUENTLY. SHE ALWAYS KNEW ME
11 WHEN I WENT TO VISIT HER. ON A WEEKLY BASIS WE'D CALL HER
12 EXTENDED FAMILY IN MARYLAND, SHE'D CARRY ON CONVERSATIONS
13 WITH THOSE PEOPLE.
14 Q. YOU'VE TOLD US THAT WHEN YOUR MOTHER COMPLAINED OF
15 HEADACHES -- AND YOU'VE SAID HAD SHE COMPLAINED OF HEADACHES
16 HER WHOLE LIFE?
17 A. YES.
18 Q. AND THEN SHE ALSO COMPLAINED OF HEADACHES AT THE END OF
19 HER LIFE AND YOU DIDN'T CONSIDER YOUR MOM HAD DEMENTIA, YOU
20 DID THINK THAT SOMETIMES SHE WAS CONFUSED. AM I CORRECT,
21 THOUGH, MRS. BRINGHURST, THAT WHEN YOUR MOTHER WOULD COMPLAIN
22 OF THOSE HEADACHES, YOU FREQUENTLY BELIEVED THAT THE
23 COMPLAINTS OF HEADACHES WERE JUST ATTENTION-GETTING
24 BEHAVIORS?
25 A. YES. I OFTENTIMES WOULD HAVE, HAVING KNOWN HER ALL MY
1 LIFE.
2 Q. SO YOU DIDN'T BELIEVE YOUR MOTHER WHEN SHE SAID I HAVE A
3 HEADACHE, AM I RIGHT?
4 A. NOT ALL THE TIME.
5 Q. RIGHT. THANK YOU.
6 AND, OF COURSE, I DON'T MEAN TO BE SILLY ABOUT THIS, BUT
7 YOU COULDN'T GET INSIDE OF YOUR MOTHER, YOU COULDN'T KNOW
8 WHETHER SHE WAS FEELING PAIN OR NOT FEELING PAIN?
9 A. THAT'S CORRECT. BUT LIKE I TOLD MR. WILSON, YOU COULD
10 SEE THE ANGUISH ON HER FACE WHEN YOU COULD REALLY TELL THAT
11 SHE HAD A HEADACHE.
12 Q. THERE IS NO PAINOMETER, THERE IS NO DEVICE THAT MEASURES
13 PAIN, DO YOU AGREE WITH THAT?
14 A. THAT'S CORRECT.
15 Q. AND IT'S ALSO TRUE, ISN'T IT, MA'AM, THAT I THINK YOU
16 TOLD MR. WILSON ABOUT THIS THAT ON SOME OCCASIONS WHEN YOUR
17 MOTHER REPORTED PAIN, YOU WERE AWARE THAT YOUR MOTHER WAS
18 BEING GIVEN A PLACEBO?
19 A. THAT'S CORRECT.
20 Q. AND THE PLACEBO WAS BEING GIVEN BECAUSE YOU FREQUENTLY
21 WOULD INTERACT WITH THE NURSING STAFF AND ADVISE THE NURSING
22 STAFF THAT YOU DIDN'T REALLY THINK YOUR MOM WAS EXPERIENCING
23 PAIN, ISN'T THAT RIGHT?
24 A. YES. AND THE NURSING STAFF WOULD MAKE THAT
25 DETERMINATIONS ALSO.
1 Q. BUT YOU WOULD INTERACT WITH THEM AND TELL THEM, I DON'T
2 REALLY THINK THIS IS REAL, I DON'T REALLY THINK MOM'S IN
3 DISCOMFORT, I THINK SHE'S JUST DOING THIS FOR ATTENTION?
4 A. MOM RECEIVED CALCIUM MANY MORE TIMES THAN WHEN I WAS AT
5 THE HOSPITAL WHEN THAT EVENT OCCURRED.
6 Q. OKAY. IN THE LAST SEVERAL MONTHS BEFORE YOUR MOTHER WAS
7 TRANSPORTED TO NORTH DAVIS, THE GEROPSYCHIATRIC UNIT, DO YOU
8 REMEMBER IF IN THE LAST IN THE MONTH OF NOVEMBER AND DECEMBER
9 YOUR MOTHER WAS COMPLAINING OF PAIN VERY OFTEN DURING THAT
10 TIME FRAME?
11 A. I DON'T REMEMBER SPECIFICALLY, SIR.
12 Q. AND WOULD IT SURPRISE YOU TO KNOW THAT YOUR MOTHER
13 RECEIVED LORTAB - HYDROCODONE - ALMOST EVERY DAY FOR THE MONTHS
14 OF NOVEMBER AND DECEMBER OF 1995?
15 A. NO. BECAUSE AS I SAID, SHE DID HAVE THE EXTRA STRENGTH
16 TYLENOL ORDERED AND THE HYDROCODONE WHICH IS LORTAB OR
17 HYPHIN.
18 Q. WELL, EXTRA STRENGTH TYLENOL IS DIFFERENT FROM HYPHIN.
19 A. I UNDERSTAND. BUT AS I UNDERSTAND HYPHIN AND LORTAB ARE
20 THE SAME, THEY ARE HYDROCODONE.
21 Q. RIGHT, RIGHT.
22 A. AND I KNEW THAT SHE WAS RECEIVING THEM.
23 Q. SO IT DOESN'T SURPRISE YOU THEN THAT IN THE LAST -- IN
24 NOVEMBER AND DECEMBER THAT SHE RECEIVED LORTAB ALMOST EVERY
25 DAY? THAT DOESN'T SURPRISE YOU?
1 A. NO.
2 Q. AND WHAT YOU EXPLAINED TO THE JURY IS THAT YOU DID
3 UNDERSTAND THAT THE NURSES WOULD ADMINISTER THE MEDICATIONS
4 IF THEY BELIEVED YOUR MOTHER WAS IN PAIN?
5 A. YES. AS THEY WERE ORDERED BY THE PHYSICIAN.
6 Q. AND SO WOULD THERE BE SOME INDICATION THAT YOUR MOTHER
7 WAS FEELING SOME DISCOMFORT SINCE SHE RECEIVED HYDROCODONE
8 EVERY DAY FOR THE LAST TWO MONTHS BEFORE SHE WAS MOVED TO THE
9 GEROPSYCHIATRIC UNIT?
10 A. THAT IT WAS INTERPRETED THAT WAY BY THE NURSING STAFF.
11 Q. OKAY. THANK YOU.
12 NOW, I THINK YOU'VE MENTIONED WITH MR. WILSON, BUT ONE OF
13 THE PROBLEMS YOUR MOTHER HAD WAS THAT SHE HAD THIS -- SHE HAD
14 A FLUID RESTRICTION OR SHE WAS ON FLUID INTAKE RESTRICTION,
15 IS THAT RIGHT?
16 A. YES.
17 Q. BECAUSE SHE WAS CONSTANTLY THIRSTY APPARENTLY?
18 A. WELL, LIKE I TOLD MR. WILSON, THIS HAD GONE ON FOR
19 SEVERAL YEARS STARTING IN THE LATE 1980'S AND WE WENT TO
20 SEVERAL DOCTORS AND CHANGED MEDICATION, CHECKED HER KIDNEY
21 FUNCTIONS, COULD NEVER FIND A REASON FOR THIS CHRONICALLY LOW
22 SODIUM AND THE FLUID RESTRICTION WAS THE ONLY THING THAT --
23 Q. MRS. BRINGHURST, WERE YOU AWARE THAT YOUR MOTHER WAS FROM
24 TIME-TO-TIME DRINKING FROM TOILETS?
25 A. THE NURSES HAD REPORTED THAT THERE IN MONTH OF DECEMBER.
1 Q. WOULD THAT SUGGEST TO YOU, MRS. BRINGHURST, THAT YOUR
2 MOTHER WAS QUITE DISORIENTED TO BE DRINKING FROM A TOILET? I
3 KNOW THAT YOU DON'T THINK SHE HAD DEMENTIA, BUT I'M JUST
4 ASKING WOULD YOU AGREE THAT THAT WOULD SUGGEST A CERTAIN
5 AMOUNT OF CONFUSION?
6 A. I THINK SHE WAS VERY, VERY THIRSTY. THAT MAY SOUND ODD
7 TO YOU, BUT I JUST THINK THAT SHE WAS VERY, VERY THIRSTY.
8 Q. ON. THANK YOU.
9 NOW, YOU DIDN'T ACTUALLY SEE YOUR MOTHER'S COMBATIVENESS
10 OR STATES OF AGITATION THAT NECESSITATED THE ALZHEIMER UNIT
11 OR THE SPECIAL NEEDS UNIT IN COMING TO YOU AND SAYING, HEY,
12 WE THINK -- WE'VE GOT TO MOVE YOUR MOM, WE CAN'T CONTROL HER
13 HERE. YOU DIDN'T ACTUALLY SEE ANY OF THESE DISTURBING
14 BEHAVIORS THAT THE STAFF COULDN'T CONTROL?
15 A. NOW, ARE YOU REFERRING TO THE TIME SHE MOVED FROM THE
16 LONG-TERM CARE AREA TO THE SPECIAL NEEDS UNIT OR FROM
17 SPECIAL NEEDS TO GEROPSYCH?
18 Q. THANK YOU FOR CLARIFYING THAT. IT WAS REALLY
19 WELL-WORDED.
20 IN MID DECEMBER OF 1995 WHEN YOUR MOM MOVED FROM THE
21 SPECIAL NEEDS UNIT OF THE NORTH DAVIS HOSPITAL, THAT HAPPENED
22 AS I UNDERSTAND YOUR TESTIMONY, BECAUSE THE INTERDISCIPLINARY
23 STAFF AT THE SPECIAL NEEDS UNIT SAID WE CAN'T CONTROL YOUR
24 MOM, THERE'S ALL THESE DISTURBING BEHAVIORS, SHE'S JUST TOO
25 MUCH FOR US?
1 A. THAT'S CORRECT.
2 Q. THAT'S WHAT THEY TOLD YOU, RIGHT?
3 A. RIGHT. AND I DID NOT WITNESS THAT. I WAS QUITE
4 SURPRISED.
5 Q. THAT'S MY -- THAT'S EXACTLY MY POINT.
6 A. YES.
7 Q. IT CAME AS A SURPRISE TO YOU, YOU THOUGHT YOUR MOM WAS
8 FINE AND IT WAS A SURPRISE TO YOU THAT THE STAFF SAID WE JUST
9 CAN'T CONTROL YOUR MOM HERE?
10 A. CORRECT.
11 Q. OKAY. SO EVEN THOUGH YOU VISITED YOUR MOM FREQUENTLY YOU
12 JUST NEVER SAW ANY OF THESE WILD, WILDLY AGITATED BEHAVIORS
13 THAT THE NURSING STAFF COULDN'T CONTROL?
14 A. NO. WHEN I WAS THERE IF SHE NEEDED SOMETHING, SHE
15 REQUESTED OF ME.
16 Q. OKAY. THANK YOU.
17 BUT THEN I THINK -- I THOUGHT I UNDERSTOOD YOU TO SAY
18 THAT ON THE DAY THAT YOU DID TAKE YOUR MOM TO THE HOSPITAL
19 WHICH I GUESS WAS DECEMBER 28TH, AM I RIGHT?
20 A. YES.
21 Q. THAT WAS THE DAY THAT YOU REMEMBER THAT YOUR MOM, AGAIN,
22 HAD VERY GOOD MENTAL CLARITY?
23 A. SHE KNEW WHERE WE WERE GOING AND THAT THEY WERE GOING TO
24 WORK ON HER MEDICATION TO TRY TO HELP HER FEEL BETTER. SHE
25 SEEMED TO UNDERSTAND.
1 Q. SHE SEEMED LUCID TO YOU?
2 A. YES.
3 Q. SHE SEEMED TO BE UNDERSTANDING THINGS?
4 A. WHAT WE WERE DOING.
5 Q. SHE DIDN'T SEEM CONFUSED TO YOU THAT DAY?
6 A. I THINK IF ANYTHING THERE WAS SOME CONFUSION ONLY BECAUSE
7 WE WERE MOVING HER FROM A TOTALLY DIFFERENT ENVIRONMENT. BUT
8 AS WE TALKED ABOUT IT, IT MADE SENSE WHAT WE WERE DOING.
9 Q. YOU INTERPRETED IT THAT YOUR MOTHER UNDERSTOOD THAT YOU
10 WERE MOVING HER TO TRY TO HELP IMPROVE HER QUALITY OF LIFE?
11 A. YES. THAT'S EXACTLY WHEN THE FACILITY TOLD US THEY WOULD
12 DO.
13 Q. AND THAT'S WHAT YOU TRIED TO COMMUNICATE TO YOUR MOM?
14 A. YES.
15 Q. AND YOU TOLD YOUR MOM THAT THEY'RE GOING TO TRY TO ADJUST
16 YOUR MEDICATIONS?
17 A. YES.
18 Q. TO MAKE YOU FEEL BETTER?
19 A. YES.
20 Q. AND THEN YOU WERE WITH YOUR MOM AT HER ADMISSION, I
21 GUESS, YOU TOLD MR. WILSON THAT?
22 A. YES.
23 Q. ON DECEMBER 28TH, IS THAT RIGHT?
24 A. THAT'S CORRECT.
25 Q. AND COULD WE SEE MEDICAL RECORD 294. I'M NOT SURE IF YOU
1 CAN FIND THAT FOR ME. MA'AM, IF YOU'LL HOLD ON.
2 MRS. BRINGHURST, I'M GOING TO HAVE TO TURN SOME PAGES,
3 THEN I'LL HAVE TO TELL YOU WHERE TO GO. THIS IS -- COULD YOU
4 TURN FOR PAGE 14 OF THE SLIDES. I'VE GIVEN YOU --
5 MRS. BRINGHURST, ARE YOU THERE?
6 A. YES, MA'AM -- SIR.
7 Q. SO THIS IS THE NURSING ADMISSION ASSESSMENT AND DOES IT
8 SOUND FAMILIAR THAT YOU WERE PRESENT WITH YOUR MOM WHEN THIS
9 WAS FILLED OUT?
10 A. THAT'S CORRECT.
11 Q. AND ON THE TOP IT HAS THE NAME MARY. DID YOU FILL THAT
12 IN OR DO YOU THINK THE NURSE WROTE IN THE NAME THERE?
13 A. NO. THAT'S NOT MIGHT HANDWRITING. THAT WAS FILLED OUT
14 BY THE NURSING STAFF.
15 Q. AND COULD WE TURN TO THE PAGE AND MAY I -- AND YOU MA'AM
16 TO TURN TO PAGE 16?
17 THE COURT: WHAT'S THE MEDICAL RECORD.
18 MR. BUGDEN: MEDICAL RECORD 298, JUDGE. THIS IS
19 EXHIBIT 4B 298.
20 Q. (BY MR. BUGDEN) AND THEN COULD WE HAVE THE BLOW UP,
21 PLEASE.
22 SO THIS WAS ON A DAY YOU BELIEVED YOUR MOTHER UNDERSTOOD
23 WHAT WAS HAPPENING. AND ON A PAIN SCALE OF ONE TO FIVE YOUR
24 MOTHER RATED HER PAIN AS A FIVE?
25 A. YES.
1 Q. DOES THAT SOUND RIGHT?
2 A. I SEE THAT. I DON'T RECALL IT HAPPENING BUT I SEE IT
3 CHARTED THERE.
4 Q. IN DESCRIBING PROBLEMS WITH BONES AND JOINTS, IT SAID
5 THAT SHE HAD FALLS, HISTORY OF BACK PAIN, AND THE HIP
6 FRACTURE, IS THAT RIGHT?
7 A. IN REALITY THE HIP FRACTURE WAS A PELVIC FRACTURE IT
8 WASN'T THE FEMORAL HEAD.
9 Q. DID YOU THINK YOUR MOTHER WAS JUST TELLING THE NURSING
10 ASSESSMENT -- OR THE NURSE THAT HER PAIN WAS A FIVE ON A
11 SCALE OF ONE TO FIVE JUST FOR ATTENTION AT THAT POINT?
12 A. I DON'T KNOW THAT I CAN TELL YOU THAT. WE HAD DRIVEN
13 PROBABLY 45 MILES FROM SANDY UP TO LAYTON WITH MOM SITTING IN
14 THE CAR, SHE MAY HAVE HAD MORE PAIN AT THAT POINT.
15 Q. THEN COULD WE TURN TO -- OR MAY I ASK YOU, MA'AM, TO TURN
16 TO PAGE 18 AND IT'S MED-302, JUDGE. AND THEN THERE'S A BLOW
17 UP, SAME PAGE.
18 WHAT WOULD YOU LIKE MOST -- WHAT WOULD YOU LIKE TO CHANGE
19 HERE? MY PAIN.
20 A. I SEE THAT.
21 Q. I GUESS, YOU DON'T REALLY REMEMBER YOUR MOM SAYING THAT?
22 A. NO. I DON'T REMEMBER SPECIFIC ANSWERS TO THE QUESTIONS.
23 Q. OKAY. NOW, ALTHOUGH IT WAS A SURPRISE TO YOU THAT THE
24 SPECIAL NEEDS UNIT COULDN'T HANDLE YOUR MOTHER'S PROBLEMS,
25 YOU ACCEPTED THAT WHILE THEY DON'T -- THEY DON'T FEEL THEY
1 CAN HANDLE MOM ANYMORE SO WE'RE GOING TO GO THIS TO
2 GEROPSYCHIATRIC HOSPITAL, WE'RE GOING TO ADJUST THE MEDS, YOU
3 UNDERSTOOD THAT, IS THAT RIGHT?
4 A. WE WERE GIVEN NO OPTION. EITHER MOVE HER TO A ANOTHER
5 LONG TERM FACILITY OR TO THE GEROPSYCH UNIT.
6 Q. SO LIKE IT OR NOT, THE FACILITY SHE WAS IN, THEY NO
7 LONGER WOULD ACCEPT HER?
8 A. THAT'S CORRECT.
9 Q. AND YOU UNDERSTOOD, ALTHOUGH YOU HAD NOT SEEN ANY OF THE
10 WILD AGITATION OR ANY OF THE BEHAVIORS THAT THE NURSING STAFF
11 SAID MADE HER AN UNSUITABLE CANDIDATE FOR THEIR SPECIAL NEEDS
12 UNIT, YOU UNDERSTOOD THAT THE WHOLE REASON TO GO TO THE
13 HOSPITAL NOW WAS HOPEFULLY THAT THE HOSPITAL COULD GET THIS
14 AGITATION -- AGAIN, BEHAVIOR YOU DIDN'T YOU HARDLY EVER SAW,
15 BUT THAT MAYBE THE HOSPITAL COULD GET THIS UNDER CONTROL?
16 A. THE GEROPSYCH UNIT COULD ADJUST HER MEDICATIONS AND
17 IMPROVE HER WELL-BEING --
18 Q. QUALITY OF LIFE?
19 A. -- QUALITY OF LIFE.
20 Q. RIGHT?
21 A. HER --
22 Q. AND THE MEDS, THOUGH -- YOU'RE A NURSE AND YOU KNEW THAT
23 WHAT THEY MEANT WAS EITHER THE HOSPITAL WAS GOING TO TIE HER
24 DOWN, PHYSICALLY RESTRAIN HER OR THEY WERE GOING TO MEDICATE
25 HER. AND MEDICATION WOULD BE BETTER THAN TYING HER DOWN?
1 A. I ANTICIPATED ADJUSTMENT OF HER PSYCHIATRIC MEDICATIONS.
2 Q. SO IT NEVER EVEN OCCURRED TO YOU THAT THEY MIGHT TIE HER
3 DOWN?
4 A. NO. I DON'T THINK I GOT TO THAT TYPE OF A THOUGHT
5 PROCESS THAT THAT WOULD BE NECESSARY.
6 Q. BUT YOU DID UNDERSTAND THAT THEY WOULD BE MEDICATING HER,
7 RIGHT?
8 A. ADJUSTING HER MEDICATIONS.
9 Q. OKAY. ADJUSTING HER MEDICATIONS. AND YOU KNEW THAT THAT
10 WOULD MEAN PSYCHOTROPIC MEDICATIONS?
11 A. YES.
12 Q. AND YOU KNEW THAT PART OF TRYING TO CONTROL AGITATION AT
13 LEAST AT SOME LEVEL IS TO SEDATE THE PERSON, IS TO CALM DOWN,
14 YOU UNDERSTOOD THAT, DIDN'T YOU?
15 A. TO SOME DEGREE.
16 Q. EXCUSE ME --
17 A. TO SOME DEGREE.
18 Q. THANK YOU. AND THEN WHEN YOU WOULD VISIT YOUR MOM YOU
19 DID NOTICE WHAT YOU THOUGHT WAS A CHANGE IN HER ALERTNESS
20 WHEN YOU WOULD VISIT HER, IS THAT RIGHT?
21 A. THAT'S CORRECT.
22 Q. SHE SEEMED SLEEPIER OR MORE DROWSY WHEN YOU WOULD VISIT
23 HER?
24 A. YES.
25 Q. AND YOU ASKED THE NURSING STAFF ABOUT THAT AND THEY SAID,
1 WELL, SHE'LL ADJUST TO THAT?
2 A. THE RESPERIDAL WAS ALL I WAS TOLD. THE RISPERDAL I'M NOT
3 FAMILIAR WITH THE DRUG, I'M NOT A PSYCHIATRIC NURSE. BUT
4 THAT WAS THE ONE THAT THEY SAID SHE WAS RECEIVING AND SHE
5 WOULD ADJUST TO THE DOSAGE AND NOT BE SO SLEEPY.
6 Q. OKAY. NOW AS A NURSE YOU KNEW THAT YOU COULD LOOK AT HER
7 MEDICATION LOG, YOU COULD REQUEST FOR SEE HER MEDICATION LOG
8 IS THAT RIGHT?
9 A. THAT'S RIGHT. FROM MY EXPERIENCE WITH NURSING OR HAVING
10 PATIENTS OTHER FAMILY MEMBERS OUT ON NURSING UNIT ON A
11 TYPICAL DAY-TO-DAY BASIS FAMILY MEMBERS DO NOT LOOK AT THE
12 MEDICAL RECORDS.
13 Q. YOU RESPECTED THE NURSING STAFF THAT WAS TAKING CARE OF
14 YOUR MOM AT DAVIS NORTH, RIGHT?
15 A. THAT THEY WERE DOING WHAT WAS SUPPOSED TO BE DONE, THEY
16 WERE THE EXPERTS IN THE FIELD AND THAT THEY WERE TELLING ME
17 THE TRUTH.
18 Q. AND YOU WERE DEFERRING TO THEM WHEN THEY SAID, WELL,
19 SHE'LL ADJUST TO THE MEDS?
20 A. CORRECT.
21 Q. YOU DIDN'T EVER ASK TO SPEAK FOR DR. WEITZEL AT THAT
22 POINT TO ASK ABOUT THE MEDICATIONS, IS THAT RIGHT?
23 A. AS I RECALL, I NEVER WAS ABLE TO -- I DON'T RECALL
24 SPECIFICALLY ASKING.
25 Q. TO TALK TO HIM?
1 A. BUT I DON'T RECALL I NEVER SAW HIM.
2 Q. BUT YOU NEVER ASKED TO TALK TO HIM ABOUT THIS ISSUE, DID
3 YOU?
4 A. RIGHT. NO. THE NURSES WERE ALWAYS THERE, THE SOCIAL
5 WORKERS THE -- I DON'T RECALL THE NAMES OF THE SPECIAL TEAMS
6 THEY HAD BUT THESE OTHER GROUP THERAPY TEAMS.
7 Q. OKAY. NOW, DO I UNDERSTAND YOUR TESTIMONY CORRECTLY,
8 MRS. BRINGHURST, THAT YOU WERE UNAWARE THAT YOUR MOTHER HAD
9 SUFFERED A SEIZURE DURING HER HOSPITALIZATION?
10 A. AT THE GERIATRIC PSYCHIATRIC UNIT?
11 Q. RIGHT.
12 A. I WAS -- I WAS CALLED ON SUNDAY AFTERNOON. I WAS OUT
13 SHOPPING WITH MY DAUGHTER AND RECEIVED A PAGE AND THAT WAS
14 WHEN THE NURSES SAID YOUR MOTHER'S HAD EITHER A SEIZURE OR A
15 STROKE AND WE NEED YOU TO COME TO THE HOSPITAL.
16 Q. BEFORE THE SEIZURE AND THE STROKE INFORMATION WAS
17 CONVEYED TO YOU, DID YOU KNOW THAT YOUR MOTHER -- DID YOU
18 KNOW THAT YOUR MOTHER HAD BEEN REFERRED FOR A CONSULTATION TO
19 A DR. MEEK?
20 A. THE GYNECOLOGIST, YES.
21 Q. AND WERE YOU AWARE THAT YOUR MOTHER HAD A RECTAL VAGINAL
22 FISTULA?
23 A. YES. FROM THAT -- THE NURSING STAFF INFORMED ME.
24 Q. OKAY. NOW, COULD WE SEE MED 336 AND IN JUST A MOMENT I'M
25 GOING TO ASK YOU TO TURN TO SLIDE 22. (THE COURT:) THIS IS EXHIBIT?
1 MR. BUGDEN: 4B, JUDGE, PAGE 336.
2 THE COURT: OKAY. FOURTEEN.
3 Q. (BY MR. BUGDEN) THIS IS PART OF A MEDICAL DIRECTIVE THAT
4 YOUR MOTHER HAD SIGNED, IS THAT RIGHT?
5 A. YES, FROM THE NURSING HOME.
6 Q. IN 1991?
7 A. YES.
8 Q. AND SARAH ANDERSON WAS HER PHYSICIAN AT THAT TIME?
9 A. THAT'S CORRECT.
10 Q. AND YOUR MOTHER ACTUALLY SIGNED THIS IN HER OWN WRITING AT
11 THIS TIME?
12 A. THAT'S CORRECT.
13 Q. YOU'RE, OF COURSE, FAMILIAR WITH MEDICAL DIRECTIVES AS A
14 NURSE, IS THAT RIGHT?
15 A. TO A CERTAIN EXTENT. BEING IN THE OPERATING ROOM WE'RE
16 NOT EXPOSED TO THAT ON A DAY-TO-DAY BASIS.
17 Q. WELL, AS YOU CAN SEE YOUR MOTHER HAD MADE SOME DECISIONS
18 BACK IN 1991 ABOUT WHAT SORTS OF THINGS SHE WOULD WANT TO DO
19 IN TERMS OF EITHER RECEIVING TREATMENT OR THE WITHHOLDING OF
20 TREATMENT, IS THAT RIGHT?
21 A. YES.
22 Q. AND THEN SHE MADE CHECKMARKS AND THAT'S YOUR MOM'S
23 SIGNATURE DOWN HERE AT THE BOTTOM, IS THAT RIGHT?
24 A. YES. AS I RECALL THIS WAS FILLED OUT WITH ONE OF THE
25 SOCIAL WORKERS AT THE NURSING HOME WITH THE SOCIAL WORKER
1 ASKING MOM THE QUESTIONS. I WASN'T THERE BUT THAT WAS --
2 WHEN I INQUIRED AFTERWARDS HOW DID THIS COME ABOUT, THAT'S
3 WHAT I WAS TOLD, THE SOCIAL WORKER HAD GONE OVER IT WITH MOM.
4 Q. AND YOU KNOW, THEY'RE OBVIOUSLY BOXES TO CHECK FOR WHAT
5 KIND OF MEDICAL CARE OR WITHHOLDING OF TREATMENT SHE WANTS
6 AND SHE DID WANT OXYGEN, SHE DID WANT RESPIRATION TREATMENTS,
7 SHE DID WANT SUCTION. THOSE ARE FREQUENTLY REFERRED TO AS
8 COMFORT MEASURES, SOMETHING TO MAKE THE PATIENT COMFORTABLE
9 IS THAT RIGHT?
10 A. WELL --
11 Q. SUCTIONING TREATMENT, LET'S TALK ABOUT THAT.
12 A. WELL, I THINK YOU COULD DO THAT NOT ONLY FOR COMFORT BUT
13 TO -- YEAH, YOU DON'T WITHIN A PATIENT DROWNING IN THEIR
14 SECRETIONS.
15 Q. THANK YOU.
16 AT LEAST IN '91 YOUR MOM DID NOT WANT MECHANICAL
17 VENTILATION, VENTILATORS ABOARD, CPR, ALL OF THOSE THINGS,
18 RIGHT?
19 A. UH-HUH.
20 Q. THEN SHE DIDN'T WANT ARTIFICIAL FEEDING, SHE DIDN'T WANT
21 THE NASAL GASTRIC TUBE, SHE DIDN'T WANT A GASTRIC TUBE, IS
22 THAT RIGHT?
23 A. YES.
24 Q. DO YOU THINK YOU MIGHT HAVE EVEN BEEN PRESENT WHEN YOUR
25 MOM FILLED THAT OUT?
1 A. NO. I KNOW DEFINITELY I WAS NOT PRESENT.
2 Q. AND THEN --
3 A. I -- I'M SORRY. DO YOU WANT ME TO TELL YOU HOW I KNEW I
4 WASN'T?
5 Q. NO. THANK YOU THOUGH.
6 A. OKAY.
7 Q. THEN ON DECEMBER 28TH, THAT WAS UPON YOUR MOTHER'S
8 ADMISSION TO THE HOSPITAL, IS THAT RIGHT?
9 A. 1995.
10 Q. 1995?
11 A. YES.
12 Q. YOU SIGNED ANOTHER MEDICAL DIRECTIVE, IS THAT RIGHT?
13 A. THE NEXT PAGE, YES.
14 Q. AND DR. WEITZEL WAS NOT PRESENT ON THE DAY THAT YOU WITH
15 SOME NURSING STAFF FILLED THIS OUT, ISN'T THAT RIGHT?
16 A. THERE IS, THAT'S CORRECT.
17 Q. AND AM I CORRECT THAT AS MUCH AS POSSIBLE YOU TRIED TO
18 DUPLICATE YOUR MOTHER'S OWN WISHES FROM THE 1991 MEDICAL
19 DIRECTIVE THAT WE JUST LOOKED AT WITH THE JURY?
20 A. THAT'S CORRECT. I HAD THIS FROM THE NURSING HOME AND
21 FILLED IT OUT ACCORDINGLY THE WAY MOM HAD REQUESTED IT.
22 Q. OKAY. SO THERE'S NO QUESTION THAT WE'RE TALKING ABOUT --
23 WELL, FIRST THIS IS YOUR SIGNATURE, IS THAT RIGHT?
24 A. YES.
25 Q. KAREN BRINGHURST?
1 A. YES.
2 Q. AND YOU KNEW, OF COURSE, THAT YOU WERE FILLING THIS OUT
3 FOR YOUR MOM?
4 A. THERE WAS A STAMP UP THERE.
5 Q. A STAMP THAT WE CAN'T QUITE SEE. YOU CAN SEE IT MAYBE ON
6 YOUR COPY.
7 A. A LITTLE BIT, YES.
8 Q. AND THIS IS THE DAY OF THE ADMISSION, RIGHT?
9 A. YES.
10 Q. AND, AGAIN, YOU JUST TRIED TO FULFILL YOUR MOTHER'S
11 WISHES? THIS DOCUMENT WAS YOUR INTENT OR ATTEMPT TO HONOR
12 YOUR MOTHER'S WISHES ABOUT WHAT SHE WOULD WANT DONE IF SHE
13 BECAME ILL?
14 A. THAT'S CORRECT.
15 Q. THEN BY JANUARY 7TH YOU WERE ADVISED -- AS YOU SAY YOU
16 WERE SHOPPING, I THINK YOU SAID, WITH YOUR DAUGHTER AND YOU
17 RECEIVED A PHONE CALL FROM THE NURSING STAFF THAT SAID YOUR
18 MOTHER HAD SUFFERED A SEIZURE, WAS ILL AND THAT YOU SHOULD
19 COME AND VISIT HER?
20 A. THEY SAID A SEIZURE AND/OR A STROKE AND I NEEDED TO COME
21 TO THE HOSPITAL.
22 Q. WERE YOU AWARE THAT THE INTERNIST THAT PROVIDED
23 CONSULTATION TO THE PATIENTS IN THE GEROPSYCHIATRIC UNIT, A
24 MAN BY THE NAME OF DR. DIENHART, THAT HE ALSO HAD CONCLUDED
25 THAT YOUR MOTHER WAS ON THE EVE OF DEATH, THAT SHE WAS ON THE
1 VERGE OF DYING, WERE YOU AWARE OF THAT?
2 A. I DON'T RECALL THAT I EVEN KNEW THAT ANY OTHER PHYSICIAN
3 CAME TO SEE MOTHER.
4 Q. COULD WE SEE MED 250. IS THERE A BLOW UP OF THAT PAGE.
5 ALTHOUGH THIS IS LIKE A LOT OF PHYSICIANS, IT'S NOT
6 ALWAYS THE EASIEST HANDWRITING TO READ. I THINK IT'S MAYBE
7 THE NEXT PAGE.
8 A. IS THIS?
9 Q. YES, MA'AM.
10 A. OKAY.
11 Q. YOU'LL SEE ALTHOUGH IT'S THE NO EASIEST TO READ, IT'S
12 1/7/96, I SUSPECT SHE MAY DIE SOON. AND YOU'LL JUST HAVE TO
13 TAKE MY REPRESENTATION, IT SAYS ADVISED FAMILY AND
14 DR. DIENHART.
15 YOU WEREN'T AWARE THAT AN INTERNAL MEDICINE DOCTOR HAD
16 EVER BEEN TREATING YOUR MOM DURING HER HOSPITALIZATION?
17 A. FROM RECALL, I DON'T. FROM READING THE RECORDS SINCE
18 THIS PROCEEDING STARTED I -- I SEE IT.
19 Q. OKAY. AND THEN WHEN DID YOU GO TO THE HOSPITAL -- YOU
20 CAN TURN THAT OFF -- YOU DID MEET WITH YOUR MOTHER, YOU DID
21 VISIT WITH YOUR MOM, IS THAT RIGHT?
22 A. WELL, WE WERE UNABLE TO VISIT SHE --
23 Q. I'M SORRY. BUT YOU --
24 A. WE WERE WITH MY MOTHER.
25 Q. AND WHEN YOU WENT IN TO VISIT WITH HER YOU COULD SEE THAT
1 SHE REALLY WAS GOING DOWN HILL, YOU COULD SEE THAT FOR
2 YOURSELF?
3 A. YES.
4 Q. AND YOU HAD A CONVERSATION WITH DR. WEITZEL, IS THAT
5 RIGHT?
6 A. YES.
7 Q. AND DR. WEITZEL ADVISED YOU THAT HE THOUGHT THAT YOUR
8 MOTHER WAS DYING?
9 A. YES.
10 Q. AND HE TOLD YOU THAT HE THOUGHT THAT -- YOU ASKED WHAT
11 COULD BE DONE?
12 A. YES.
13 Q. AND HE SAID, WELL, WE CAN TRY TO KEEP HER COMFORTABLE?
14 A. WE CAN GIVE HER MORPHINE AND KEEP HER COMFORTABLE AND
15 HASTEN THE INEVITABLE.
16 Q. GIVE HER MORPHINE, KEEP HER COMFORTABLE WHICH MIGHT
17 HASTEN THE INEVITABLE, ISN'T THAT WHAT HE SAID?
18 A. NO. I RECALL HIM SAYING AND HASTEN THE INEVITABLE.
19 MR. BUGDEN: YOUR HONOR, MAY WE APPROACH THE BENCH?
20 THE COURT: YOU MAY.
21 (DISCUSSION WAS HELD OFF THE RECORD.)
22 MR. BUGDEN: THANK YOU. MAY I APPROACH THE WITNESS,
23 YOUR HONOR.
24 THE COURT: YOU MAY.
25 Q. (BY MR. BUGDEN) MRS. BRINGHURST, I'VE JUST ASKED YOU A
1 COUPLE OF QUESTIONS IN PARTICULAR ABOUT DR. WEITZEL'S
2 CONVERSATION WITH YOU. I'M GOING TO SHOW YOU A DOCUMENT
3 THAT'S IN YOUR HANDWRITING. AND THAT'S YOUR SIGNATURE, ISN'T
4 IT?
5 A. UH-HUH.
6 Q. WOULD YOU PLEASE READ TO THE JURY WHAT YOU'VE WRITTEN
7 STARTING WITH THE PHRASE FAMILY MEMBERS AND JUST READ TO THE
8 END OF THE PAGE, PLEASE.
9 A. THE FAMILY MEMBERS RESPONDED IMMEDIATELY AND GATHERED AT
10 THE HOSPITAL. DR. WITEFUL (SIC) --
11 Q. WEITZEL.
12 A. -- EXCUSE ME, DR. WEITZEL INFORMED MY HUSBAND AND
13 THAT WHATEVER HAD HAPPENED TO MOM WAS PROBABLY NOT REVERSIBLE
14 AND SHE PROBABLY WOULD NOT SURVIVE. I ASKED WHAT COULD BE
15 DONE. DR. WEITZEL SAID WE CAN GIVE HER MORPHINE TO KEEP HER
16 COMFORTABLE AND IT MAY HASTEN THE INEVITABLE AND I SAID THANK
17 YOU.
18 Q. AND YOU'VE SIGNED IT?
19 A. THAT'S CORRECT.
20 MR. BUGDEN: THAT'S ALL I HAVE. THANK YOU. YOUR
21 WITNESS.
22 THE COURT: REDIRECT, MR. WILSON.
23 MR. WILSON: YES.
24 REDIRECT EXAMINATION
25 BY MR. WILSON:
1 Q. I'M GOING TO HAND YOU WHAT'S MARKED AS STATE'S EXHIBIT 4A
2 WHICH IS THE NURSING HOME RECORDS RELATING TO YOUR MOTHER AND
3 ASK YOU TO TAKE A LOOK AT THOSE IF YOU WOULD, PLEASE.
4 FIRST OF ALL, COULD YOU TURN TO PAGES 554 AND 555 IN THE
5 NURSING HOME RECORD.
6 A. OKAY.
7 Q. AS I UNDERSTAND IT, I THINK THIS IS THE ALTA VIEW
8 HOSPITAL EMERGENCY ROOM DEPARTMENT REPORT?
9 A. IT LOOKS LIKE IT, YES.
10 Q. AND COUNSEL ASKED YOU A COUPLE OF QUESTIONS CONCERNING
11 THIS REPORT. WOULD YOU GO DOWN TO THE PHYSICAL EXAMINATION
12 AND INDICATE WHAT YOUR MOTHER'S TEMPERATURE WAS AT THAT TIME?
13 A. 103.7.
14 Q. AND IN RESPECT TO THE SECOND PAGE THERE WAS SOME
15 QUESTIONS RELATED TO THE TREATMENT, WOULD YOU GO DOWN TO THE
16 ANALYSIS AND READ THAT, IF YOU WOULD, PLEASE.
17 A. THIS PATIENT HAS WHAT APPEARS TO BE A URINARY TRACT
18 INFECTION AND IS PROBABLY SEPTIC.
19 Q. AND IT'S WHAT?
20 A. AND IS PROBABLY SEPTIC.
21 Q. IS THAT PROBABLY OR POSSIBLY?
22 A. I'M SORRY, MEL. IT IS POSSIBLY. POSSIBLY SEPTIC.
23 Q. OKAY. IN RESPECT TO YOUR EARLIER TESTIMONY, DID YOU
24 INDICATE THAT YOUR MOTHER SEEMED MORE CONFUSED WHEN
25 EXPERIENCING A URINARY TRACT INFECTION?
1 A. YES, SHE DID AT TIMES.
2 Q. OKAY. NOW, THERE WAS A NUMBER OF QUESTIONS THAT WERE
3 ASKED TO YOU ABOUT THE PLACEBO THAT WAS GIVEN TO YOUR MOTHER,
4 THE CALCIUM PILL. CAN YOU TELL US WHETHER THAT PLACEBO
5 APPEARED TO BE EFFECTIVE?
6 A. YES. AT TIMES IT WOULD AND IT'S DOCUMENTED IN THE
7 NURSING HOME MEDICAL RECORD.
8 Q. OKAY. NOW, I WANT YOU TO TURN TO PAGES IT LOOKS LIKE 846
9 AND THAT PARTICULAR EXHIBIT. WHICH APPEARS TO BE A NARCOTIC
10 RECORD OR HAVE YOU FOUND THAT YET.
11 A. IT'S UNDER THE NARCOTIC SECTION?
12 Q. UH-HUH.
13 A. I DON'T SEE THE PAGE NUMBERS ON THESE PAGES.
14 Q. IT'S RIGHT UP AT THE TOP JUST UNDERNEATH.
15 A. OH, YES, THERE IS IT IS. OKAY. 846.
16 Q. OKAY.
17 A. YES.
18 Q. CAN YOU IDENTIFY FROM LOOKING AT THAT THE TIME PERIOD
19 THAT WE'RE TALKING ABOUT AND WHAT THAT RECORD IS ABOUT?
20 A. THIS IS A RECORD FOR THE HYDROCODONE OR OTHERWISE KNOWN
21 AS LORTAB OR HYPHIN MEDICATIONS GIVEN TO MOM FROM -- EXCUSE
22 ME OCTOBER 21ST, 1995 THROUGH NOVEMBER 22ND SHOWS ONE PILL
23 GIVEN AT A TIME A TOTAL OF 30 PILLS IN THAT TIME FRAME.
24 Q. AND NOW TURN TO THE NEXT PAGE WHICH WOULD BE 851 WHICH IS
25 ALSO IDENTIFIED AS A NARCOTIC RECORD. TELL US WHAT TIME
1 PERIOD THAT COVERS IF YOU WOULD, PLEASE.
2 A. I CAN'T SEE THE PAGE NUMBER ON THIS ONE -- AGAIN, IS IT?
3 MS. BARLOW: LOWER RIGHT-HAND CORNER.
4 THE WITNESS: YES, THANK YOU VERY MUCH. YES. THIS
5 IS PART OF IT IS COPIED OFF BUT IN LOOKING DOWN IT LOOKS LIKE
6 IT WOULD BE 11/23 OF '95 TO 12.27 OF '95 THE SAME RECORD FOR
7 HYDROCODONE, 30 TABLETS ONE GIVEN EACH TIME AS IT'S CHARTED
8 HERE.
9 Q. (BY MR. WILSON) SO ESSENTIALLY SHE WAS RECEIVING ONE
10 PILL A DAY?
11 A. IT APPEARS ONE PILL A DAY.
12 Q. WERE YOU AWARE THAT YOUR MOTHER BEEN TREATED WITH A
13 DURAGESIC PATCH?
14 A. AT THE GEROPSYCHIATRIC UNIT?
15 Q. YES.
16 A. NO, I WAS NOT.
17 Q. WERE YOU EVER MADE AWARE PRIOR TO THE 7TH THAT SHE WAS
18 INDEED RECEIVING INJECTIONS FOR MORPHINE?
19 A. NO, I WAS NOT.
20 MR. WILSON: I HAVE NO FURTHER QUESTIONS, YOUR
21 HONOR -- OH, YES, I DO, JUDGE.
22 Q. (BY MR. WILSON) GOING BACK TO YOUR CONVERSATION WITH THE
23 DEFENDANT ON THE 7TH. DURING THAT DISCUSSION DID THE
24 DEFENDANT EVER OFFER ANY OTHER TREATMENT ALTERNATIVES?
25 A. NO. THERE WERE NONE OFFERED.
1 MR. WILSON: THANK YOU.
2 THE COURT: RECROSS MR. BUGDEN.
3 RECROSS-EXAMINATION
4 BY MR. BUGDEN:
5 Q. MA'AM, YOUR A NURSE, IS THAT RIGHT?
6 A. YES.
7 Q. YOU'RE A SURGICAL NURSE?
8 A. YES.
9 Q. YOU'RE CERTAINLY YOU CERTAINLY WERE AWARE ON THAT DATE
10 THAT THE INTENSIVE CARE UNIT WAS AVAILABLE, IS THAT RIGHT?
11 A. WE WERE RIGHT NEXT DOOR TO THE HOSPITAL, YES.
12 Q. SO YOU COULD HAVE CHOSEN, ALTHOUGH DR. WEITZEL BELIEVED
13 YOUR MOTHER WAS GOING TO PASS AWAY, YOU COULD HAVE DIRECTED
14 HIM TO SEND YOUR MOTHER TO ICU INTENSIVE CARE UNIT, ISN'T
15 THAT RIGHT?
16 A. FROM MY EXPERIENCE WHEN THE FAMILIES ARE IN THAT KIND OF
17 SITUATION THEY'RE NOT THINKING CLEARLY AND DISTRAUGHT AND
18 I'VE ALWAYS BEEN UNDER THE IMPRESSION IT'S THE RESPONSIBILITY
19 OF THE MEDICAL AND NURSING STAFF TO DIRECT THE FAMILY MEMBERS
20 AS TO THE OPTIONS AVAILABLE.
21 Q. SO YOU DIDN'T -- BECAUSE DR. WEITZEL -- YOU DON'T
22 REMEMBER HIM SPECIFICALLY SAYING YOU COULD PUT YOUR MOM OR WE
23 CAN SEND YOUR MOM TO INTENSIVE CARE UNIT, IT NEVER OCCURRED
24 TO YOU DURING THAT CONVERSATION THAT, GEE, WE HAVE THE OPTION
25 TO SEND MOM RIGHT NEXT DOOR TO CRITICAL CARE? THAT NEVER
1 CROSSED YOUR MIND?
2 A. NO. AND WHEN I ASKED HIM WHAT WE COULD DO IT WAS NOT
3 OFFERED. I SAID WHAT CAN WE DO FOR MOM.
4 Q. WELL, HE EXPRESSED HIS OPINION THAT WE CAN KEEP HER
5 COMFORTABLE. AND MY POINT IS: IT NEVER CROSSED YOUR MIND
6 THAT, GEE, WE COULD GO ANOTHER WAY HERE, THERE'S A PATH IN
7 THE ROAD, A FORK IN THE ROAD, WE COULD SEND MOM TO CRITICAL
8 CARE? THAT NEVER OCCURRED TO YOU?
9 A. NO. BECAUSE HE TOLD ME WHAT HAPPENED WAS NOT REVERSIBLE
10 AND SHE WAS NOT EXPECTED TO SURVIVE. SO AT THAT POINT, THERE
11 WAS NO SENSE TO SEND HER TO ICU BASED ON WHAT HE WAS SAYING.
12 Q. AND HE HAD TOLD YOU THAT HE THOUGHT SHE HAD HAD A SEIZURE
13 OR SOMETHING LIKE THAT, IS THAT RIGHT?
14 A. DR. WEITZEL DID NOT SAY THAT. THE NURSING STAFF SAID
15 THAT TO ME. HE SAID WHATEVER HAPPENED.
16 Q. WHATEVER HAPPENED. AND DID YOU ASK HIM, WELL, WHAT IS
17 THAT YOU THINK DID HAPPEN TO MY MOM?
18 A. NO. I WAS GOING BY WHAT THE NURSING STAFF HAD TOLD ME,
19 IT WAS EITHER A STROKE OR A SEIZURE.
20 Q. SO, AGAIN, IT NEVER OCCURRED TO YOU IF YOU WANTED TO KNOW
21 EXACTLY WHAT HAD WHAT HAD MADE YOUR MOTHER SO ILL, IT NEVER
22 OCCURRED TO YOU THAT YOU COULD SAY, YOU KNOW, LET'S DO SOME
23 MORE TESTING TO SEE EXACTLY WHAT'S WRONG WITH MY MOM? THAT
24 NEVER OCCURRED TO YOU?
25 A. IT DIDN'T BECAUSE I KNEW MOM WAS TOO FAR GONE AT THAT
1 POINT TOTALLY UNRESPONSIVE.
2 Q. THANK YOU.
3 THE COURT: MR. WILSON, ANYTHING FURTHER?
4 MR. WILSON: NO. I HAVE NOTHING FURTHER, YOUR
5 HONOR.
6 THE COURT: YOU MAY STEP DOWN. THANK YOU FOR
7 TESTIFYING, MS. BRINGHURST. MAY THIS WITNESS BE EXCUSED,
8 MR. WILSON?
9 MR. WILSON: SHE MAY.
10 THE COURT: MR. BUGDEN?
11 MR. BUGDEN: YES, SIR.
12 THE COURT: THANK YOU FOR TESTIFYING.